Open AccessArticle
A Retrospective Study of the Impact of 21-Gene Recurrence Score Assay on Treatment Choice in Node Positive Micrometastatic Breast Cancer
by
Thomas G. Frazier, Kevin R. Fox, J. Stanley Smith, Christine Laronga, Anita McSwain, Devchand Paul, Michael Schultz, Joseph Stilwill, Christine Teal, Tracey Weisberg, Judith F. Vacchino, Amy P. Sing, Dasha Cherepanov, Wendy Hsiao, Eunice Chang and Michael S. Broder
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Abstract
To assess clinical utility of the 21-gene assay (Onco
type DX
® Recurrence Score
®), we determined whether women with HER2(−)/ER+ pN1mi breast cancer with low (<18) Recurrence Scores results are given adjuvant chemotherapy in a lower proportion than those with high
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To assess clinical utility of the 21-gene assay (Onco
type DX
® Recurrence Score
®), we determined whether women with HER2(−)/ER+ pN1mi breast cancer with low (<18) Recurrence Scores results are given adjuvant chemotherapy in a lower proportion than those with high scores (≥31). This was a multicenter chart review of ≥18 year old women with pN1mi breast cancer, HER2(−)/ER+ tumors, ductal/lobular/mixed histology, with the assay ordered on or after 1 January 2007. One hundred and eighty one patients had a mean age of 60.7 years; 82.9% had ECOG performance status 0; 33.7% had hypertension, 22.7% had osteoporosis, 18.8% had osteoarthritis, and 8.8% had type-2 diabetes. Mean Recurrence Score was 17.8 (range: 0–50). 48.6% had a mastectomy; 55.8% had a lumpectomy. 19.8% of low-risk group patients were recommended chemotherapy
vs. 57.9% in the intermediate-risk group and 100% in the high-risk group (
p < 0.001). A total of 80.2% of the low-risk group were recommended endocrine therapy alone, while 77.8% of the high-risk group were recommended both endocrine and chemotherapy (
p < 0.001). The Onco
type DX Recurrence Score result provides actionable information that can be incorporated into treatment planning for women with HER2(−)/ER+ pN1mi breast cancer. The Recurrence Score result has clinical utility in treatment planning for HER2(−)/ER+ pN1mi breast cancer patients.
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